As Republican leaders in Congress scramble to come up with a replacement for the Affordable Care Act, they are quickly resurrecting America’s decades-long health care debate, in all its complexities. But it’s not clear which direction Congress and the country are headed.

On Sunday, the Washington Post reported that President-elect Donald Trump said he is close to completing a plan to replace Obamacare, with the goal of “insurance for everybody,” though he declined to discuss any details.

On Monday, Trump’s press secretary Sean Spicer was asked on NBC’s “Today” show if the President-elect’s replacement plan would expand government health care, but Spicer said that’s not the case. He said access to health insurance would be improved, and costs would be driven down through marketplace competition, including allowing insurers to sell health insurance plans across state lines.

Depending on what his plan ultimately reveals, for Trump and the Republicans, the reality of making a political misstep that might send at least 20 million newly insured Americans into the arms of their Democratic foes in the 2018 mid-term elections isn’t far from their minds.

Not one Republican in Congress voted for President Barack Obama’s landmark health care law in 2010. Now, it appears, Democrats are getting a taste of their own medicine as the Republicans push a new plan down their throats.

But a Bay Area businessman’s effort to address their polarizing dialogue — could be a sign that the American people may be longing for a bipartisan solution.

After more than a year of work, San Francisco-based Mark Zitter, founder of a pharmaceutical consulting firm, last week launched the Zetema Project, a nonprofit that is staging expert discussions to help the public better understand opposing views about U.S. health care.

“Most Americans tend to be in echo chambers talking to people they already agree with,’’ Zitter said. “It’s easy to keep things like that going — and not hear the other side — which many people think is either dumb or evil. We’re trying to be the antidote to that.’’

Zitter has assembled a diverse group of 25 U.S. health care leaders that include officials from both Democratic and Republican administrations and both aisles of Capitol Hill, as well as senior executives from health systems, insurers, Big Pharma, organized medicine and patient advocacy groups.

The group’s first meeting, which begins Tuesday in Atlanta, will involve a robust discussion about key health care issues. “We’re not trying to make recommendations,” he said. “We’re taking a different approach not to improve the system but to improve the conversation” around it.

A recent poll by the nonpartisan Kaiser Family Foundation, based in Menlo Park, found that three-fourths of those polled either oppose repealing the law (47 percent) or want to wait to repeal it until details of the GOP substitute plan are firmed up (28 percent).

But many Republicans — such as Sally Pipes, president and CEO of the Pacific Research Institute, a San Francisco-based nonprofit that promotes limited government — believe the law should be repealed as quickly as possible.

“The American people voted for Donald Trump not because they love Donald Trump,’’ said Pipes. “They are very upset about high premiums, high deductible and narrow (provider) networks.’’

A variety of replacement plans have been submitted including those by House Speaker Paul Ryan, Sens. Orrin Hatch and Rand Paul, and Tom Price, the physician and U.S. congressman who is Trump’s nominee for Health and Human Services Secretary. Patient advocates and health care experts who have studied the drafts — providing universal “access” to health insurance, but not universal “coverage” — generally agree that they help younger and healthy people more than older and sicker people, and provide less protection for people with pre-existing health conditions.

For California, the stakes couldn’t be higher. Under Obamacare, the state has reduced its uninsured rate from nearly 19 percent in 2010 to 8.6 percent in 2015 — the biggest drop of any state over the last three years.

At least five million more Californians have insurance today, including 1.2 million who are enrolled in private plans through the state’s insurance exchange, Covered California. Most of them receive government subsidies that keep their premium costs down.

But the overwhelming majority of the newly insured — 3.8 million — now are covered through a provision in the law that allows adults without children to enroll in Medi-Cal, which provides health care coverage to the poor.

The debate in Congress comes just weeks before the Jan. 31 deadline to enroll — or re-enroll — in an Obamacare plan for 2017, or face a penalty of $695 per adult, or 2.5 percent of your household income, whichever is higher.

Bay Area health insurance agents say the fight on Capitol Hill over the law has left many consumers confused — or afraid their insurance could disappear overnight.

“There has been concern like, ‘Do you think it’s going to last? Are my premiums going to change? Are we going to get knocked out of the system?” said Carol Traeger, an agent at HealthMarkets Insurance Agency in San Jose.

“And my answer is: Everything will stay the same for the year of 2017. Premiums won’t change; once you’re in, you’re in. You’re fully funded no matter what happens at the federal level,” Traeger said.

Dismayed by the rhetoric, Covered California CEO Peter Lee said he will soon be traveling to Washington, D.C., to sit down with both Democrat and Republican leaders to talk about “what has worked in California.’’

Unlike some states, Lee said, “we’ve expanded coverage dramatically and have generally kept premium increases under control, while keeping a very competitive market.’’

The Covered California’s roadmap, Lee believes, “is one that works for many other states.’’ And, like Medicare, the program Lee’s uncle Dr. Philip Lee in 1965 was tapped to help roll out under President Lyndon Johnson — all government programs need tweaking over the years to make them better, Lee has said.

Even Obamacare’s chief architect, Dr. Ezekiel Emanuel acknowledges that. And he’s holding out hope that Congress will agree to a bipartisan compromise.

Last month, Trump invited Emanuel to Trump Tower to talk about the health care law. During their 45-minute meeting, Emanuel told an audience last week at the Commonwealth Club, the president-elect asked some “very good and pointed questions,” but made clear he wants to replace the law.

Still, he added, “I think he sincerely does want to improve the system and get Americans covered.”